Hamstring pull recovery: week 3

I’m writing and publishing my (rather raw) notes on hamstring pull recovery. Notes from previous weeks: week 1, week 2.

Daily stretching, balance and strength routine

Every day I go over a subset of a routine designed to develop my core stability, stretch core and thigh muscles. I included the complete list of exercises below. I find them all really great and I think I would like to continue doing them long after my physical therapy is done. They are an enjoyable and versatile workout.

Balance

• Foot on a platform with a tiny, round stick supporting it from underneath, with two configurations for the attachment: parallel and diagonal to my foot; stand on one leg 7 times, hold until fall or for 10 seconds
• Squat-like sit on a unstable platform: sitting on my glutes with thigh and back at roughly 45 degrees to the ground and just survive without falling; I’m using a wooden platform that is supported by a metal tube of about 6cm diameter, it’s extremely unstable and I haven’t mastered reliable balancing on it yet

Core

• Plank on TRX: legs tucked into TRX’s handles and resting on my forearms, once stable, I bend my knees to the center of my chest, to the left (rotation with hips) and to the right; 4x15 reps
• Side plank: plank on one of my forearms, lifting leg slowly; 4x15 reps
• Single leg hip lift: laying on my back, one leg is bent with foot on the floor and thigh of another one parallel but with the leg extended, lift hips while watching to keep them parallel to the ground; 4x15 reps
• Roman chair (hold): on a roman chair, get into static position where the back is straight and hold it for 75s (my target: 120s); 4 reps
• Roman chair (dynamic): on a roman chair, holding a 5kg weight in front of my chest, bend down and then pull back to straight body position, the movement is initiated from hips (back stays intact); 4 reps. This exercise was surprisingly straining for my hamstring/adductor so I had to give up on it for now

Weight/strength

The excercises below are standard weightlifting techniques so I’m skipping my own descriptions of the movement.

• Sumo squats with 20kg-loaded barbell on my shoulders as a warmup (one series) and then 40kg-loaded barbell; total 3x20 reps
• Deadlift with 20kg-loaded barbell as a warmup (one series) and then 25kg-loaded barbell; total 3x20 reps
• Side lunge with 20kg-loaded barbell on my shoulders as a warmup (one series) and then same with 25kg; total 3x20reps
• Good morning: this one is less popular but easy to google, I’ve done with 25kg-loaded barbell but I found it difficult to do so I had to stop until other exercises build my muscles

After the whole routine and the rest of PT, I’m doing a series of stretches for hip flexors, glutes and the whole longitudinal back chain. I’m doing 3 reps for 30 seconds in each position.

The whole set, including stretching takes a bit over an hour to do.

Week 3

Alright, I’m ready to talk about the third week of the actual physical therapy.

Monday (June 11th, 2018 ) was the day we were still fighting the tightness of my adductor so I only did the balance and core muscles exercises (skipped side plank). We chatted with Fabienne more about the weird moving tension that I have. It’s increasingly clear that we’re puzzled how all the symptomps I experience could have a source in my semimembranosus pull.

On Tuesday, Fabienne watched me doing the weightlifting routine and corrected my deadlift. We did a fair amount of deep massage and the tightness of the adductor started to dampen. Almost a week after my unfortunate bike ride I feel a small relief.

Wednesday is when I get my dry needling done. Unfortunately, once I woke up, the adductor tightness was full back in power so we focused on dry needling of that muscle. The adductor was so stiff that Tanya had a real trouble inserting the needle. I got a big blueberry on my muscle, it’s innocuous but a sign that the dry needling session was particularly difficult — the adductor was too tight to work with it. Tanya taught me some elements of yoga in search for releasing my muscles.

As a complete side, I watched Andrej Karpathy’s Building the Software 2.0 Stack. It was pretty great. Andrej: I used to lose sleep over machine learning model architectures, now I lose sleep over data and labels.

On Thursday, the adductor stays tight-strong and the tightness extended itself to rectus femoris muscle. Fabienne did massage of both. Soon enough I’ll learn about all individual muscles in my leg by virtue of them all getting tight, one by one. It’s fascinating how I made into 30s without being aware how many muscle we have!

In addition to massage, we’ve done some new balance exercises on a platform supported by a metal tube (I’ll find the proper name of this piece of equipment next time). The balance exercises are the most fun for me (there’s no pain) and the ones I learned today are circus-level of difficulty.

Fabienne showed me deep lunge on two boxes and I really enjoyed that exercise. I felt it was the most effective releasing rectus femoris’s tightness.

Finally, as a tidbit, I learned that Manuel Neuer (regarded as the best goalkeeper in the world) was treated in Rennbahnklinik a few months ago. Famous athletes regularly visit but the clinic is under very strict NDA and can talk about its celebrity patients only long after they are gone. I kept wondering if I’m sweating next to some pros.

On Friday we continued to fight with adductor tightness. The deep massage did help. Fabienne showed me some cool exercises with battle ropes. I stood on a balancing platform and I did battle rope waves (alternating arms). Standing on a unstable platform made this an acrobatic workout. During that exercise, we saw me leaning towards left; we thought it was due to weak right adductor (the tense one). We finished off with the core muscle exercises on a stationary bike by leaning sideways and catching/throwing a medicine ball. The idea was to exercise the muscles that I can later use to stabilize my pelvis when I’m on a bike.

On Saturday, I went for a gentle version of my daily routine. In the afternoon, I took my bike for a spin. I went from Basel to Zurich to visit my friends for the weekend. The conditions of the ride were excellent: good weather and a bike path pretty much all the way between Basel and Zurich. Some spots greeted me with really nice views over rolling hills and small, meandering rivers.

I rode 90km with 1500m of elevation gain in 4 hours. The ride would have been great except my adductor stroke with a full force. It was tight pretty much from the beginning of the ride, ~10km in and the tightness slowly ramped up. Around 30km into the ride I noticed, using a small backpack as a reference surface, that my position on the bike is not straight, the adductor was pulling me sideways and causing a mild but visible scoliosis. I decided to keep going but gently and observe carefully how the tightness develops. After a while, the lower part of my quad got tense, then my calf and finally my foot. Pain covered all these areas plus goose foot (under the knee). Later into the ride, I felt pulling near the spot where gracilis attaches itself to the hip (high up, near the joint point). Once I arrived, I collected all these details in my Moleskine PT journal. I’m borrowing from that journal copiously to write these Medium posts.

In Zurich I did a solid stretching but nothing was helping. It was clear that I’m not coming back on a bike the next day. Disheartened, I took the train back on Sunday.